The gift of a label

Sometimes dealing with complex mental illness feels like you’re carrying around a list of diagnoses on your back. For a while, every time I heard something new, it was like “oh great, there’s something else wrong with me.” I’m coming to realize now that being able to find the right labels and understand them is a gift–at least for me. My list of labels looks like this: major depressive disorder (recurrent severe), generalized anxiety disorder, C-PTSD, and ADHD. It’s a big list of some scary shit. And it’s taken over twenty years of some fairly intensive treatment ranging from medication to therapy to hospitalization to get me this far in my recovery. I have come a long way. Even just in the last few years.

But here’s the thing about long-term recovery. It’s not a straight line. You make a huge step forward, and then fall back. Sometimes it feels like you fall back farther than where you started from.

As I’ve mentioned, I made a lot of progress in 2017. It’s probably–no, it’s definitely–inevitable that there would be backlash. Some of it comes from the way my mind works. When things are going well for me, inevitably at some point, I start expecting catastrophe. It’s a common trait among people with C-PTSD, to not expect anything good to last. Worse than that, I’m prone to self-sabotage when things are going ‘too’ well. It’s something I have to watch myself for closely. On top of that, as my overall mental health has improved, and my baseline functioning has improved dramatically, it’s become more apparent that I have seasonal affective disorder. (I honestly had no idea before–depression hit so often, winter didn’t seem different from any other time.) And as if all that weren’t enough, at my last psychiatrist visit, we discovered that the reason my ADHD symptoms seemed to get so much worse in October and November is because…wait for it… my doctor accidentally cut my Adderall dosage by a third. My chart was wrong, and I missed the change on the script.

So what I’m saying is: I’m struggling right now. Depressive episodes take different forms for me, because it’s a sneaky bastard of a disease, and I don’t always spot them. I recognize my ‘usual’: sadness, apathy, sleeping too much, etc. There’s a second type that’s only happened a couple of times, and that’s what’s going on now. Emotionally, I feel mostly okay, at least on the surface. Physically though, I feel like hell. I’m aching all the time, and exhausted. Like, really exhausted. And here’s where the emotional aspect is going south on me. A natural response to suddenly feeling like crap physically would be to think about going to the doctor. But this is how my thought process has been going: Of course you’re tired all the time, of course you feel like crap. You’re fat. Everyone said this would happen, and it’s happening. If you go to the doctor, that’s all they’re going to tell you. Over and over again. I started feeling ashamed of my body again, of myself.

Huge steps forward, big falls back.

Thankfully, I was able to spell this out with my therapist, and she was the one who said, “hm, this sounds like depression.” Once she said it, it was like a lightbulb going off, followed by me going “god dammit, not again.” But as always with me, labeling what’s going on with my brain gives me the tools to start fixing it. Now that I’m able to look at how I’m feeling as more of my stupid brain tricks and less of a personal failing, it’s easier to start dismantling it. Plus, for the first time in quite a while, my doctor has increased one of my antidepressant dosages.

In a strange way, one of the greatest gifts I’ve been given in the years of dealing with my various mental illnesses was my PTSD diagnosis, specifically complex PTSD. When my therapist at the time said it, I argued with her. Everybody knows PTSD happens to people who’ve been through big, terrible things, like war, or physical abuse. I wasn’t abused, of course. My childhood was a little rough, I argued, but it wasn’t abuse. She said something I’ve never forgotten. That when someone has severe mental illness symptoms, that’s an indication that the precipitating factors were also severe. And when mental illness doesn’t improve substantially with treatment, that suggests there’s more involved. I was abused, she said. By both of my parents, and as a result, was suffering from C-PTSD.

It turns out that my unwillingness to accept that is, ironically, a classic symptom of C-PTSD: we minimize what happened to us. And the more I read about PTSD symptoms, the more I saw myself: the way I startle when people approach me unexpectedly, my issues with self-worth, my fear of abandonment, etc, etc. It took me several months to realize that, as much as my parents did love me, and as much as they tried to do the right thing by me, they failed. They failed catastrophically to the point of profoundly damaging my sense of self. And it wasn’t just them, of course, there was the bullying at school and church, and other issues. It took a long time to realize that even though I didn’t face any physical violence, aside from corporal punishment (which may or may not have constituted physical abuse) and one or two fights at school, I grew up in an environment where I never felt safe. I grew up constantly receiving the message that I was not good enough, that I was unacceptably flawed. A lot of people can grow up like that and come out fighting. I didn’t. I took it all to heart. I believed it. I internalized it so deeply that over forty years later, I’m still dealing with the fallout.

And the fallout isn’t just emotional. Children who go through complex trauma like abuse experience literal physical changes to the structure of their brains. I was permanently changed. That’s one of the reasons that it’s taken so many years of therapy and treatment to get me this far. It’s not just a case of learning how to process feelings, it’s a case of finding my own ways to cope with things, because the ‘normal’ ways aren’t there for me. Those pathways don’t exist in my brain.

That was a gift to realize. Understanding C-PTSD tied together the rest of my diagnoses. It was a weight lifted, in a strange way. I was able to start to accept that I am not weak, that I wasn’t just a lazy, fragile wilting flower unable to cope with normal life like everyone else. Each diagnosis I’ve gotten, really, but especially C-PTSD and ADHD, are a message for me, one that says, “The reason everything feels so much harder for you is because they are so much harder for you. You have obstacles that other people don’t have. And here’s how you can start getting around them.”

So that’s what I’m trying to do right now. Picking myself back up and recognizing that the stumbles are as much a part of my recovery as the triumphs.